It is imperative to reduce maternal mortality in the developing world in view of the evidence like about 38% of maternal deaths occurring due to haemorrhage (Sample Registration System, India-2005) and the systematic review (WHO) of 34 datasets establishing that percentage of maternal deaths from haemorrhage was higher than previously estimated by WHO .(Khan KS et al, WHO analysis of cause of death: a systematic review, Lancet 2006;367:1066-74).
In India a revolutionary legal modification was done through a government notification in 2001 aiming to make abundant availability of blood to the blood storage centres run by FRU, Community Health Centre, PHC or any hospital without taking license.
In view of the abominably high percentage of maternal deaths occurring due to post-partum and ante-partum haemorrhages, availability of safe blood becomes crucial in preventing most of such avoidable deaths.
Prevention of maternal deaths necessitates availability of safe blood (at blood strage centres) in rural and tribal parts of all countries also (the blood banking services being predominantly based in larger cities).
Effective functioning of fully operationalized blood storage centre is a key strategic intervention to ensure that safe blood (fully processed, tested and packaged by the mother blood bank and procured by the blood storage centre with maintenance of cold chain) is available (in view of the urban centric blood banking services) in rural and tribal areas of the state also.
The blood storage centres allotted to the Community Health Centres are a great value addition to the CHC / First Referral Units (FRUs) and they are bound to go a long way in prevention of maternal deaths and ensuring appropriate use of blood for surgical indications/road traffic accidents etc.
I strongly feel that facilitation of such systemic interventions and their appropriate scale up through incorporation in the available guidelines can do wonders to slow and somewhat directionless efforts in a few of the developing countries for ensuring equitable access to safe blood.
The same will definitely go a long way in significant reduction of maternal mortality.
Thanks and best wishes,
Dr. Rajesh Gopal.